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Intra-oral elements of braces

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ARCHWIRE

The archwire is the wire that connects each brace together.  It does the actual work of aligning the braces, which will line up the teeth. It is made from a very resilient material that allows it to return to its original shape, after you bend it.  Not like a paper clip that will stay bent.  The wires come in different sizes, shapes and composition of materials.

The size of the wire is measured by the thickness of the cross-section in thousands of an inch.  A common round wire size is 0.016-inch, whereas a common rectangular wire is 0.017 by 0.025-inch.  Most of them are of stainless steel material, with various combinations of materials like chromium, cobalt, nickel, titanium and copper which greatly influence the bending properties of the wire.

BAND

A band is a metal ring that fits around the tooth.  It will have a brace welded to it and is held onto the tooth with dental cement.  They are only used on back teeth, because they do not look very nice with all that metal showing.  In years past, all of the teeth had bands on them, which is where the term “metal mouth” comes from.  But with invention of bonding (gluing) a brace directly to the tooth, you do not have to use bands on the front teeth anymore.  Holding a brace onto a tooth with a band is much more durable than bonding it directly to the tooth.  This durability is very important when you have people exerting hundreds of pounds of pressure to their teeth when they chew.  They can easily break a bonded brace loose from a tooth, but not a banded one.  This is why bands are still used today and why the orthodontists ask their patients not to chew hard or eat crunchy food.

BRACKETS

Brackets are the tiny braces that are attached to the teeth.  They act like handles that allow you to grab onto the teeth to move them.  They are usually bonded (glued) directly to the enamel of the tooth, except on a back tooth, where it is first welded to a band of metal and the band is then held onto the tooth with dental cement.  There are different types of braces: metal, clear and gold.  Metal braces are the most popular with orthodontists, because they are the most durable.  They are made from stainless steel materials like chromium, zinc, nickel or titanium.  The braces today are much smaller than they were several decades ago.  Clear braces are made from a ceramic material named aluminum oxide.  They are more fragile and are bulkier.

LINGUAL HOLDING ARCH

A lingual arch is a space maintainer for the lower teeth. It maintains the molars where they are, it does not move them.  This is fabricated by placing bands on the molars and connecting them to a wire that fits up against the inside of the lower teeth.  It keeps the molars from migrating forward and prevents them from blocking off the space of teeth that develop later.  This is used when you have the early loss of baby teeth or when you have lower teeth that are slightly crowded in a growing child and you do not want to remove any permanent teeth to correct the crowding.

 

TRANSPALATAL ARCH

A transpalatal arch fits on the inside of the upper molars.  It consists of bands on the molars with a thick wire that connects them.  It has several functions, but is mainly used to rotate molars, counter negative actions from other appliances, and anchor teeth against reciprocal actions.

RAPID PALATAL EXPANDER

A rapid palatal expander will expand the upper jaw to the sides.  This is the same as a palatal expander.  It is used when the upper jaw is too narrow for the lower jaw.    
The expander can be either banded or bonded to the teeth.  Banded ones have the expander attached to a band around the tooth, whereas the bonded ones have a plastic section that is bonded over the back teeth. A patient’s vertical growth pattern and age of development will determine which type to use. Both types have a screw section that is turned for the expansion.

LIGATURE TIE (Colour and Steel)

The arch wire is held to the brace by means of a ligature tie.  This tie fits under the corners of the brace, but over the arch wire.  This is needed to tighten the arch wire into the brace. The ligature ties are usually little rubber rings, but narrow steel wires can also be used.  The rubber ligature ties are simply stretched around the corners of the brace, whereas the steel ones are twisted into place.  This twisting action is where the term “tightening” comes from.  The brace is not actually tightened; it is the steel ligature tie that is tightened.  The rubber ties are usually grey in color, but they also come in a variety of bright colors.  So if you see someone with colors on their teeth, it is the ties that are colored, not the braces.

POWER CHAIN

Power chain is a row of rubber ligature ties that are connected together.  They resemble a chain because each little rubber ring is attached to the next one in the row.  The chain is stretched over a group of braces, with each ring going around one brace.  As the stretched chain wants to contract, it pulls the braces closer together.  This is utilized when closing gaps between adjacent teeth.

ELASTICS (Rubber Bands)

Elastics are rubber bands that you hook from one brace to another to provide a force that will move the teeth.  They can be used to slide one tooth along an archwire or to move a group of teeth.  They come in a variety of sizes and strengths.  Not everyone needs to wear these, as they are only needed to move teeth specifically.

 

SEPARATOR (Rubber ring or Metal wire)

A separator is also called a spacer.  It is a rubber ring or metal wire that is used to create space between teeth.  This is used on teeth that will be getting a band placed around them.  The teeth usually fit very tightly next to each other.  The tightness is something you notice when you floss.  In order to make space for the thickness of the band, you need to place a separator between the teeth for about a week to push them apart.

TEMPORARY ANCHORAGE DEVICES (T.A.D.s)

The use of T.A.D.s for orthodontic anchorage is widely used and accepted an come mainly in two forms i.e. mini-screws or bore plates.

T.A.D.s are changing the way orthodontists treat some malocclusions. They provide a body fixed point from which forces to move teeth are applied. They can be placed in many different sites in the mount - customized for each patient's needs. T.A.D.s may contribute to more predictable results and shorter treatment time.

T.A.D.s are made from titanium alloy which is not rejected by the body. They are placed with minimal invasion in most cases. They are used in patients with permanant teeth who have good oral hygene. They cause little or no discomfort and require only routine brushing and flossing.

The time a T.A.D is left in the mouth depends on the orthodontist's need for it and can vary from a few months to the whole treatment time.

 
 
 

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